Out-of-Network Fees
We are an “out-of-network” provider which allows us to provide treatment that will best meet your specific needs rather than adhering to what your insurance company believes is suitable for you. Even though we don’t accept insurance directly, most insurance companies provide partial reimbursement for out-of-network therapy. The majority of our clients are reimbursed for 60-80% of session fees after meeting their out-of-network deductible.
Individual Therapy: $200 per appointment
Couples Therapy: $225 per appointment
Insurance FAQ
If you have ever searched for a therapist, particularly in any major city, you know how difficult it is to find a therapist who accepts your insurance “in-network”. Clients want to work with someone they can afford and assume in-network providers are the best option for this. We suggest that you read this post in its entirety in order to better understand why this is not always not the case.
What is an “in-network” provider?
A therapist who has a contract with your insurance company with an agreed upon rate for services. After meeting your in-network deductible, you owe your therapist a set copay each appointment and your insurance company will pay the rest.
What is an “out-of-network” provider?
A therapist who doesn’t have a contract with your insurance company but can still bill them for coverage. After meeting your out-of-network deductible, you owe your therapist a percentage of the session fee each appointment and your insurance company will pay the rest.
What is “private-pay”?
An option for clients who don’t have coverage or don’t want to use their insurance benefits.
What is a deductible?
The amount of money you have to spend before your insurance benefits kick in. This resets once a year. An “in-network” deductible and “out-of-network” deductible are two separate things.
Why am I having trouble finding a therapist who is in-network?
How do I know what my out-of-network benefits are?
Call the member services number on the back of your insurance card and ask the below questions. The insurance representative will most likely ask for a CPT code for the specific service. 90834 is for individual therapy and 90847 is for couples therapy.
1. Do I have out-of-network coverage for routine, mental health, telehealth appointments?
2. What is my out-of-network deductible for routine, mental health, telehealth appointments?
3. How much of this yearly deductible have I met so far?
4. When does my deductible reset?
5. What is my out-of-network coinsurance for routine, mental health, telehealth appointments?
6. Is pre-authorization required for out-of-network, routine, mental health, telehealth appointments?
7. Is there a limit to the amount of yearly sessions I can have for out-of-network, routine, mental health, telehealth appointments?
8. My provider charges $200 per session for out-of-network, routine, mental health, telehealth appointments. Can you confirm whether or not the “allowed amount” AKA “Usual, Customary, and Reasonable” rate is not less than $200?
* Unfortunately, you may get different information from different representatives which is why we recommend that you ask for a reference number and the representative’s name at the end of the phone call to save for your records.
